A comparative study between coblation and bipolar electrocautery tonsillectomy in children

  • Hemin Ibrahim Saeed Department of Otolaryngology, Rizgari Teaching Hospital, Erbil, Iraq
  • Abdulkhaliq Emin Department of Otolaryngology, College of Medicine, Hawler Medical University, Erbil, Iraq
  • Moyaser A. Yaseen Department of Otolaryngology, College of Medicine, Hawler Medical University, Erbil, Iraq
  • Ammar M. Saleh Department of Otolaryngology, Rizgari Teaching Hospital, Erbil, Iraq
Keywords: Tonsillectomy, Coblation tonsillectomy, Bipolar electrocautery tonsillectomy


Background and objective: Tonsillectomy with or without adenoidectomy is an operation done frequently in all otolaryngology departments all over the world. Many new surgical techniques found over the last few decades to decrease the morbidity of this surgery. This study aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy.

Methods: This prospective study was carried out on 60 patients that underwent tonsillectomy over six months from 1(st) August 2014 to 31(st) January 2015 in Rizgary Teaching Hospital, Erbil city. They patients equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 2.5-12 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding.

Results: There was no statistically significant difference in the mean operation time between the coblation group and bipolar electrocautery group (6.89 min vs. 7.83 min, P = 0.11). The mean intraoperative blood loss was statistically lower for the bipolar electrocautery group versus the coblation group (1.43 ml vs. 15.37 ml, P <0.001). There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. No episodes of primary or secondary hemorrhage were recorded.

Conclusion: Bipolar electrocautery tonsillectomy offers the same operative speed, less intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.


Özler GS, Tatar EC. Comparing traditional cold knife tonsillectomy with a new technique plasma knife tonsillectomy. Turk Arch Otolaryngology 2013; 51:114–7.

Businco LDR, Tirelli GC. Pediatric tonsillectomy: Radiofrequency-based plasma dissection compared to cold dissection with sutures. (Accessed January 19, 2011 at http://www.businco.it/studio).

Shah SA, Ghani R. Evaluation of safety of bipolar diathermy tonsillectomy. J Ayub Med Coll Abbottabad 2007; 19(4):94– 7.

Oko MO, Ganly I, Loughran S, Clement WA, Young D, Geddes NK. A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group. Otolaryngol Head Neck Surg 2005; 133(4):579–84.

Back L, Paloheimo M, Ylikoski J. Traditional tonsillectomy compared with bipolar radiofrequency thermal ablation tonsillectomy in adults. Arch Otolaryngol Head Neck Surg 2001; 127(9):1106–10.

Roje Z, Racic G, Dogas Z, PisacVP, Timms M. Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: A prospective randomized single-blind study, Coll Antropol 2009; 33(1):293–8.

Mitic S, Tvinnereim M, Lie E, Saltyte BL. A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 2007; 32:261–7.

Philpott CM, Wild DC, Mehta D, Daniel M, Banerjee AR. A double-blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on postoperative symptoms. Clin Otolaryngol 2005; 30:143–8.

Parker D, Howe L, Unsworth V, Hilliam R. A randomised controlled trial to compare postoperative pain in children undergoing tonsillectomy using cold steel dissection with bipolar haemostasis versus coblation technique. Clin Otolaryngol 2009; 34:225–31.

Xuanqian X, Nandini D. Comparison of coblation tonsillectomy and electrocautery tonsillectomy inpediatric patients. Technology Assessment Unit of the McGill University Health Centre 2008; 7(34):47–53.

Matin MA. Coblation tonsillectomy versus blunt dissection tonsillectomy. The ORION Medical J 2006; 23:330–1.

Belloso A, Chidambaram A, Morar P, Timms MS. Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage. Laryngoscope 2003; 113:2010–3.

Javed F, Sadri M, Uddin J, Mortimore S, Parker D. A completed audit cycle on post-tonsillectomy haemorrhage rate: Coblation versus standard tonsillectomy. Acta Otolaryngol 2007; 127(3):300–4.

Shapiro N L, Bhattacharyya N. Cold dissection versus coblation-assisted adenotonsillectomy in children. Laryngoscope 2007; 117:406–10.

Isaacson G. Tonsillectomy healing. Ann Otol Rhinol Laryngol 2012; 121(10):645–9.

Parsons SPCordes, SR Comer B. Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol Head Neck Surg 2006; 134:106–13.

Magdy EA, Elwany S, El-Daly AS, Abdel-Hadi M, Morshedy MA. Coblation tonsillectomy: A prospective, double-blind, randomized, clinical and histopathological comparison with dissection–ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008; 122:282–90.

Chang KW. Randomized controlled trial of coblation versus electrocautery tonsillectomy. Otolaryngol Head Neck Surg 2005; 132:273–80.

Fawzy AH, Hussien A, Ashour B. Coblation versus bipolar diathermy for adult tonsillectomy. Med.J Cairo Univ 2012; 80(1):491–4.

Tan AK, Hsu PP, Eng SP, Nq YH, Lu PK, Tan SM, et al. Coblation vs electrocutery tonsillectomy: Postoperative recovery in adults. Otolaryngol Head Neck Surg 2006; 135(5):699–703.

Pham V, Rana N. Postoperative outcomes in coblation versus electrocautery tonsillectomies. Int J Otolaryngol Head Neck Surg 2014; 3:32–41.

Stoker KE, Don DM. Pediatric total tonsillectomy using coblation compared to conventional electrocautery: A prospective controlled single-blind study. Otolaryngol Head Neck Surg 2004; 130(6):666–75.

Temple RH, Timms MS. Paediatriccoblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001; 6:195–8.

Soy FK, Dündar R, Yazici H, Kulduk E, Aslan M, Sakarya EU. Bipolar cautery tonsillectomy using different energy doses: pain and bleeding. Int J Pediatr Otorhinolaryngol 2014; 78(3):402–6.

Hong SM, Cho JG. Coblation vs. electrocautery tonsillectony: A prospective randomized study comparing clinical outcomes in adolescents and adults. Clin Exp Otorhinolaryngol 2013; 6(2):90–3.

How to Cite
Saeed, H., Emin, A., Yaseen, M., & Saleh, A. (2019). A comparative study between coblation and bipolar electrocautery tonsillectomy in children. Zanco Journal of Medical Sciences (Zanco J Med Sci), 23(1), 81-89. https://doi.org/10.15218/zjms.2019.011
Original Articles